Abstract
Abnormal talotarsal joint mechanics leading to hyperpronation is implicated as one
of the most common causes of plantar fasciopathy. In patients with hyperpronating
feet, the plantar fascia experiences excessive tensile forces during static and dynamic
weight-bearing activities because of excessive medial longitudinal arch depression.
For the purposes of this study, we hypothesized that plantar fascia strain in hyperpronating
cadaveric feet would decrease after intervention with an extra-osseous talotarsal
stabilization (EOTTS) device. A miniature differential variable reluctance transducer
was used to quantify the plantar fascia strain in 6 fresh-frozen cadaver foot specimens
exhibiting flexible instability of the talotarsal joint complex (i.e., hyperpronation).
The strain was measured as the foot was moved from its neutral to maximally pronated
position, before and after intervention using the HyProCure® EOTTS device. The mean plantar fascia elongation was 0.83 ± 0.27 mm (strain 3.62%
± 1.17%) and 0.56 ± 0.2 mm (strain 2.42% ± 0.88%) before and after intervention, respectively
(N = 18, variation reported is ± 1 SD). The average plantar fascia strain decreased
by 33%, and the difference was statistically significant with p < .001. From this cadaveric experiment, the reduction in plantar fascia strain suggests
that an EOTTS device might be effective in stabilizing the pathologic talotarsal joint
complex and the medial longitudinal arch and in eliminating hyperpronation. An EOTTS
procedure might offer a possible treatment option for plantar fasciopathy in cases
in which the underlying etiology is abnormal talotarsal biomechanics.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 16, 2011
Footnotes
Financial Disclosure: This research study was funded by GraMedica, LLC (Macomb, MI).
Conflict of Interest: Michael E. Graham is the inventor of HyProCure®. He is the Founder and President of GraMedica, LLC, the company that manufactures and distributes HyProCure®. He is also the Founder of Graham International Implant Institute.
Identification
Copyright
© 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
